<div class=grid_18>
<div class=grid_10> 
    <div class=block-border> 
        <div class=block-header> 
            <h1>SDA Church - Kwabrafoso: Enter Transfer Out</h1><span></span> 
        </div> 

        <form id=validate-form class="block-content form" action="add" method=post>

            <div class=_50> 
                <p><label for=stextarea>Transfer ID</label> 
                    <input id="transoutid" name="transoutid" class="required" class="input-xlarge" type="text" value=""/></p> 
            </div>  
       
            <div class=_50> 
                <p><label for=textarea>Membership No</label>
                    <input id="mshipno" name="mshipno" class="" type="text" value=""/></p> 
            </div> 
            
            <div class=_50> 
                <p><label for=textarea>Name</label>
                    <input id="name" name="name" class"=required" type="text" value=""/></p> 
            </div> 
            
            <div class=_50> 
                <p><label for=datepicker>Transfer Date</label>
                    <input type=date id="transdate" name="transdate" value=""/></p> 
            </div>

            <div class=_50>
                  <p><label for=select>Division</label> 
                    <select name="divname" id="divname" class="required" type="text"> 
                        <option value="Please Select Division">Please Select Division</option> 
                        <option value="Ashanti">Ashanti</option> 
                        <option value="Brong Ahafo">Brong Ahafo</option> 
                        <option value="Central">Central</option> 
                        <option value="Eatern">Eatern</option> 
                        <option value="Greater Accra">Greater Accra</option>
                        <option value="Headquarters">Headquarters</option> 
                        <option value="Northern">Northern</option> 
                        <option value="Upper East">Upper East</option> 
                        <option value="Upper West">Upper West</option> 
                        <option value="Volta">Volta</option> 
                        <option value="Western">Western</option> 
                    </select>
                </p>
            </div> 

            <div class=_50>
                  <p><label for=select>Union</label> 
                    <select name="uniname" id="uniname" class="required" type="text"> 
                        <option value="Please Select Union">Please Select Union</option> 
                        <option value="Ashanti">Ashanti</option> 
                        <option value="Brong Ahafo">Brong Ahafo</option> 
                        <option value="Central">Central</option> 
                        <option value="Eatern">Eatern</option> 
                        <option value="Greater Accra">Greater Accra</option>
                        <option value="Headquarters">Headquarters</option> 
                        <option value="Northern">Northern</option> 
                        <option value="Upper East">Upper East</option> 
                        <option value="Upper West">Upper West</option> 
                        <option value="Volta">Volta</option> 
                        <option value="Western">Western</option> 
                    </select>
                </p>
            </div> 

            <div class=_50>
                  <p><label for=select>Conference</label> 
                    <select name="confname" id="confname" class="required" type="text"> 
                        <option value="Please Select Conference">Please Select Conference</option> 
                        <option value="Ashanti">Ashanti</option> 
                        <option value="Brong Ahafo">Brong Ahafo</option> 
                        <option value="Central">Central</option> 
                        <option value="Eatern">Eatern</option> 
                        <option value="Greater Accra">Greater Accra</option>
                        <option value="Headquarters">Headquarters</option> 
                        <option value="Northern">Northern</option> 
                        <option value="Upper East">Upper East</option> 
                        <option value="Upper West">Upper West</option> 
                        <option value="Volta">Volta</option> 
                        <option value="Western">Western</option> 
                    </select>
                </p>
            </div> 

            <div class=_50>
                  <p><label for=select>Region</label> 
                    <select name="regname" id="regname" class="required" type="text"> 
                        <option value="Please Select Region">Please Select Region</option> 
                        <option value="Ashanti">Ashanti</option> 
                        <option value="Brong Ahafo">Brong Ahafo</option> 
                        <option value="Central">Central</option> 
                        <option value="Eatern">Eatern</option> 
                        <option value="Greater Accra">Greater Accra</option>
                        <option value="Headquarters">Headquarters</option> 
                        <option value="Northern">Northern</option> 
                        <option value="Upper East">Upper East</option> 
                        <option value="Upper West">Upper West</option> 
                        <option value="Volta">Volta</option> 
                        <option value="Western">Western</option> 
                    </select>
                </p>
            </div> 

            <div class=_50>
                  <p><label for=select>District</label> 
                    <select name="distname" id="distname" class="required" type="text"> 
                        <option value="Please Select District">Please Select District</option> 
                        <option value="Ashanti">Ashanti</option> 
                        <option value="Brong Ahafo">Brong Ahafo</option> 
                        <option value="Central">Central</option> 
                        <option value="Eatern">Eatern</option> 
                        <option value="Greater Accra">Greater Accra</option>
                        <option value="Headquarters">Headquarters</option> 
                        <option value="Northern">Northern</option> 
                        <option value="Upper East">Upper East</option> 
                        <option value="Upper West">Upper West</option> 
                        <option value="Volta">Volta</option> 
                        <option value="Western">Western</option> 
                    </select>
                </p>
            </div> 

            
            <div class=_50> 
                <p><label for=textarea>Town</label>
                    <input id="town" name="town" class="required" type="text" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Local Church</label>
                    <input id="chuname" name="chuname" class="required" type="text" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Business Meeting No</label>
                    <input id="buzmeetingno" name="buzmeetingno" class="required" type="text" value=""/></p> 
            </div> 
             
            <div class=block-actions> 
                <ul class=actions-left> 
                    <li><a class="button red" id=reset-validate-form href="javascript:void(0);">Reset</a></li> 
                </ul> 
                <ul class=actions-right> 
                    <li><input type=submit id="Save-Transfer In" class="button" value="Save Record"></li> 
                </ul> 
            </div> 
        </form> 
    </div> 
</div> 
</div>